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Researchers, veterinary and health care practitioners, and agricultural producers gathered in Johnston, Iowa, to attend the eighth annual Midwest Rural Agricultural Safety and Health Forum (MRASH), November 2009. Among several focus areas, four plenary talks were given on the current research being conducted examining methicillin-resistant Staphylococcus aureus (MRSA) on swine farms in the United States. These focused on prevalence of MRSA on farms, both in swine and in human workers; the presence of MRSA in air samples and in swine barn shower facilities; and the presence of methicillin-resistant and methicillin-sensitive S. aureus in retail meats. These findings begin to elucidate the overall picture of livestock-associated MRSA in the Midwestern United States.

As methicillin-resistant Staphylococcus aureus (MRSA) has been found in pigs, we sought to determine if MRSA is present in pork production shower facilities. In two production systems tested, 3% and 26% of shower samples were positive for MRSA. spa types identified included t034, t189, t753, and t1746.

Antipsychotic users were followed for up to six months using an intent-totreat approach. Extended Cox proportional hazard regression model stratified on matched pairs based on the propensity score was used to evaluate the comparative risk of death among users of typical and atypical antipsychotic agents. RESULTS: There were 84, 162 (42, 081 atypical and 42, 081 typical) users of antipsychotic agents in the final matched cohort. The unadjusted mortality rate was 11.12% (4, 682) for atypical users and 15.01% (6, 318) for typical users. Results of Cox regression suggest that, typical users were more likely to die compared to atypical users [Hazard Ratio (HR) 1.59, 95% Confidence Interval (CI) 1.52-1.66]. The extended Cox model revealed that the risk of death was greater with typical use during the initial 40 days of treatment [Ͻ40days: HR 2.00, 1.86-2.15]. The difference in risk persisted after 40 days of typical antipsychotic use [40-180 days: HR, 1.40, 1.32-1.47]. CONCLUSIONS: The use of typical antipsychotic agents was associated with shortterm and long-term risks of mortality among elderly dual eligible beneficiaries compared to atypical use. Given the underlying poor health status of dual eligible beneficiaries, the study findings suggest that the use of typical agents needs to be optimized in the vulnerable elderly population.

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